I presented a paper recently at a meeting in my nation's capital. It was at a meeting that brought together senior staff from youth serving agencies, universities and various levels of government. We gathered to talk about outcome measures for children and family services. This is a hot topic in Canada as we move towards a more “business” approach in our social services. This has been going on for a number of years in Canada influenced by a similar trend in the United States as well as a rather long period here of fiscal restraint and cutbacks. Many in this country would say that this conservative, business orientation has created a mean spirited, competitive environment in which agencies that are the most resource rich grow on the backs of the smaller agencies that do not have the skill set to play the funding game in this new world. Clients are numbers to be counted and “consumers” to be served rather than real people with real problems. I’m not meaning to carry out a debate on this “new way” in Canada. Rather I am just trying to explain the context in which the meeting was held. We came together to discuss how to measure client success within agencies. In this country the funding organizations are demanding that they receive more bang for their buck. They want the agencies to prove that the money they receive is being used effectively. They want the “business” of serving people to be able to prove that the product produced meets the need of the “consumer”.
You need to know that I am not opposed to the development of outcome measures or gages of success. After all, this should lead to improved services. I believe that we have for too long been sloppy in many of our services in that we intervene in ways that we think work without ever knowing if they actually do work. We have all seen the horrors that can occur when people go off in the latest trendy way to impose some sort of magic cure upon people in need. Outcome measures can help us to do what works rather than work we think or feel what works. This can only help our clients by giving them access to effective services. Who could seriously oppose the improvement of services?
No, I have actively supported this movement towards measurement.
What I am opposed to is that we have been moving down this path in Canada without thinking about the possible negative consequences. This to me is, once again, the same old game. Do what we are told by our funders without thinking about what it may mean to our clients. That is not to say that there will be negative consequences. I don’t know if this will be the case. I just haven’t heard any discussion about the possibility. It seems right so we do it. This to me is problematic. We need to think before we act rather than tramping merrily down the garden path.
Anyhow at this meeting a colleague and I presented a paper on the ethics of outcome measures. We weren’t trying to present an answer. What we were trying to do was to get people think about the possible consequences of what we are doing in terms of measuring success. We were successful in that the discussion after our presentation was enthusiastic and at times heated. In this way we got what we had hoped. We were both pleased by the response although not everyone agreed with what we had to say. That was okay. However, what worried me was that someone emphatically stated that a discussion on ethics had no place in a discussion on outcome measures. Can you imagine that? Maybe we have already become a business. I guess we have if someone thought it was okay to say out loud that anything we do in our field can be performed or even discussed outside the context of ethics.